| Premier Internal Medicine Group Sc | |
|
2910 Harlem Ave Riverside IL 60546-1785 | |
| (708) 447-4267 | |
| (708) 447-2104 |
| Full Name | Premier Internal Medicine Group Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2910 Harlem Ave, Riverside, Illinois |
| Authorized Official Name and Position | Tahir Rohail (PRESIDENT) |
| Authorized Official Contact | 7084474267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Internal Medicine Group Sc 2910 S Harlem Ave Riverside IL 60546-1785 Ph: (708) 447-4267 | Premier Internal Medicine Group Sc 2910 Harlem Ave Riverside IL 60546-1785 Ph: (708) 447-4267 |
| NPI Number | 1194730713 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 07/20/2010 |
| Medicare PECOS PAC ID | 9739104670 |
|---|---|
| Medicare Enrollment ID | O20051011000796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194730713 | NPI | - | NPPES |
| 036087235 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036087235 (Illinois) | Primary |
| Provider Name | Tahir Rohail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104025139 PECOS PAC ID: 2769477942 Enrollment ID: I20051011000929 |
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